Usage of Chewing Gum in Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial

Study Design. Randomized controlled trial. Objective. The present study investigated the effectiveness of chewing gum on promoting faster bowel function and its ability to hasten recovery for patients with adolescent idiopathic scoliosis (AIS) after posterior spinal fusion (PSF) surgery. Summary of Background Data. Sham feeding with chewing gum had been reported to reduce the incidence of postoperative ileus by accelerating recovery of bowel function. Methods. We prospectively recruited and randomized 60 patients with AIS scheduled for PSF surgery into treatment (chewing gum) and control group. The patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth were assessed and recorded at 12, 24, 36, 48, and 60 hours postoperatively. The timing for the first fluid intake, first oral intake, sitting up, walking, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay were also assessed and recorded. Results. We found that there were no significant differences (P > 0.05) in patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth between treatment (chewing gum) and control groups. We also found that there were no significant difference (P > 0.05) in postoperative recovery parameters, which were the first fluid intake, first oral intake, sitting up after surgery, walking after surgery, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay between both groups. The wound pain was the worst at 12 hours postoperatively, which progressively improved in both groups. The abdominal pain progressively worsened to the highest score at 48 hours in the treatment group and 36 hours in the control group before improving after that. The pattern of severity and recovery of wound pain and abdominal pain was different. Conclusion. We found that chewing gum did not significantly reduce the abdominal pain, promote faster bowel function, or hasten patient recovery. Level of Evidence: 1

[1]  K. Suh,et al.  Effect of sham feeding with gum chewing on postoperative ileus after liver transplantation—a randomized controlled trial , 2016, Clinical transplantation.

[2]  K. Suh,et al.  Effect of sham feeding with gum chewing on postoperative ileus after liver transplantation—a randomized controlled trial , 2016, Clinical transplantation.

[3]  S. Gilbert,et al.  The Use of Chewing Gum Postoperatively in Pediatric Scoliosis Patients Facilitates an Earlier Return to Normal Bowel Function , 2015, Spine deformity.

[4]  A. MacCormick,et al.  Chewing gum and postoperative ileus in adults: a systematic literature review and meta-analysis. , 2015, International journal of surgery.

[5]  L. Craciunas,et al.  Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials , 2014, BJOG : an international journal of obstetrics and gynaecology.

[6]  J. Shim,et al.  Gum chewing promotes bowel motility after a radical retropubic prostatectomy , 2014, Asia-Pacific journal of clinical oncology.

[7]  J. Shim,et al.  Gum chewing promotes bowel motility after a radical retropubic prostatectomy , 2014, Asia-Pacific journal of clinical oncology.

[8]  K. Güngördük,et al.  Influence of Gum Chewing on Postoperative Bowel Activity After Complete Staging Surgery for Gynecological Malignancies: A Randomized Controlled Trial , 2014 .

[9]  K. Güngördük,et al.  Influence of Gum Chewing on Postoperative Bowel Activity After Complete Staging Surgery for Gynecological Malignancies: A Randomized Controlled Trial , 2014 .

[10]  Justin K Scheer,et al.  Reoperation rates and impact on outcome in a large, prospective, multicenter, adult spinal deformity database: clinical article. , 2013, Journal of neurosurgery. Spine.

[11]  Justin K Scheer,et al.  Reoperation rates and impact on outcome in a large, prospective, multicenter, adult spinal deformity database: clinical article. , 2013, Journal of neurosurgery. Spine.

[12]  R. Crawford,et al.  Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience , 2013, European Spine Journal.

[13]  P. Guigui,et al.  Surgery of lumbar and thoracolumbar scolioses in adults over 50. Morbidity and survival in a multicenter retrospective cohort of 180 patients with a mean follow-up of 4.5 years. , 2012, Orthopaedics & traumatology, surgery & research : OTSR.

[14]  Munish C. Gupta,et al.  Risk factors for major peri-operative complications in adult spinal deformity surgery: a multi-center review of 953 consecutive patients , 2012, European Spine Journal.

[15]  P. Guigui,et al.  Complications and Risk Factors of Primary Adult Scoliosis Surgery: A Multicenter Study of 306 Patients , 2012, Spine.

[16]  P. Guigui,et al.  Complications and Risk Factors of Primary Adult Scoliosis Surgery: A Multicenter Study of 306 Patients , 2012, Spine.

[17]  H. Teshima,et al.  Gum chewing enhances early recovery of bowel function following transperitoneal abdominal aortic surgery , 2012, Surgery Today.

[18]  H. Teshima,et al.  Gum chewing enhances early recovery of bowel function following transperitoneal abdominal aortic surgery , 2012, Surgery Today.

[19]  Samuel K. Cho,et al.  Major Complications in Revision Adult Deformity Surgery: Risk Factors and Clinical Outcomes With 2- to 7-Year Follow-up , 2012, Spine.

[20]  K. Bridwell,et al.  Long fusions to the sacrum in elderly patients with spinal deformity , 2010, European Spine Journal.

[21]  K. Bridwell,et al.  Long fusions to the sacrum in elderly patients with spinal deformity , 2010, European Spine Journal.

[22]  M. Gray,et al.  Does Chewing Gum Shorten the Duration of Postoperative Ileus in Patients Undergoing Abdominal Surgery and Creation of a Stoma? , 2010, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[23]  M. Gray,et al.  Does Chewing Gum Shorten the Duration of Postoperative Ileus in Patients Undergoing Abdominal Surgery and Creation of a Stoma? , 2010, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[24]  M. Maltenfort,et al.  Adult scoliosis surgery outcomes: a systematic review. , 2010, Neurosurgical focus.

[25]  M. Maltenfort,et al.  Adult scoliosis surgery outcomes: a systematic review. , 2010, Neurosurgical focus.

[26]  J. Fitzgerald,et al.  Systematic Review and Meta-Analysis of Chewing-Gum Therapy in the Reduction of Postoperative Paralytic Ileus Following Gastrointestinal Surgery , 2009, World Journal of Surgery.

[27]  Ross J. Harris,et al.  Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. , 2009, International journal of surgery.

[28]  Ross J. Harris,et al.  Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. , 2009, International journal of surgery.

[29]  Adrian V. Hernández,et al.  Is Gum Chewing Useful for Ileus After Elective Colorectal Surgery? A Systematic Review and Meta-Analysis of Randomized Clinical Trials , 2009, Journal of Gastrointestinal Surgery.

[30]  Adrian V. Hernández,et al.  Is Gum Chewing Useful for Ileus After Elective Colorectal Surgery? A Systematic Review and Meta-Analysis of Randomized Clinical Trials , 2009, Journal of Gastrointestinal Surgery.

[31]  G. Andriole.  Gum Chewing Stimulates Bowel Motility in Patients Undergoing Radical Cystectomy with Urinary Diversion , 2008 .

[32]  A. Darzi,et al.  Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. , 2008, Archives of Surgery.

[33]  James D. Schwender,et al.  Complications in Long Fusions to the Sacrum for Adult Scoliosis: Minimum Five-Year Analysis of Fifty Patients , 2008, Spine.

[34]  James D. Schwender,et al.  Complications in Long Fusions to the Sacrum for Adult Scoliosis: Minimum Five-Year Analysis of Fifty Patients , 2008, Spine.

[35]  E. Wallen,et al.  Gum chewing stimulates bowel motility in patients undergoing radical cystectomy with urinary diversion. , 2007, Urology.

[36]  K. Bridwell,et al.  The Impact of Perioperative Complications on Clinical Outcome in Adult Deformity Surgery , 2007, Spine.

[37]  K. Cho,et al.  Complications in Posterior Fusion and Instrumentation for Degenerative Lumbar Scoliosis , 2007, Spine.

[38]  K. Cho,et al.  Complications in Posterior Fusion and Instrumentation for Degenerative Lumbar Scoliosis , 2007, Spine.

[39]  M. Chan,et al.  Use of Chewing Gum in Reducing Postoperative Ileus After Elective Colorectal Resection: A Systematic Review , 2007, Diseases of the colon and rectum.

[40]  M. Chan,et al.  Use of Chewing Gum in Reducing Postoperative Ileus After Elective Colorectal Resection: A Systematic Review , 2007, Diseases of the colon and rectum.

[41]  A. Maw,et al.  Does gum chewing reduce postoperative ileus following open colectomy for left‐sided colon and rectal cancer? – a prospective randomized controlled trial , 2006, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[42]  A. Maw,et al.  Does gum chewing reduce postoperative ileus following open colectomy for left‐sided colon and rectal cancer? – a prospective randomized controlled trial , 2006, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[43]  H. Kuwano,et al.  Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. , 2002, Journal of the American College of Surgeons.

[44]  H. Kuwano,et al.  Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. , 2002, Journal of the American College of Surgeons.